NPIMap

Organization Active NPI

Our Lady of Lourdes Medical Center

  • Internal Medicine Physician
  • Camden, NJ
National Provider Identifier
1013238799
Registry record updated May 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA04819100 Issued in NJ
Legal business name
OUR LADY OF LOURDES MEDICAL CENTER
Practice address
1600 Haddon Ave
Internal Medicine
Camden, NJ 08103-3101
Phone
(856) 757-3500
NPI assigned
Jun 17, 2010
Organization subpart
Yes
Parent organization
OUR LADY OF LOURDES MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 13, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Alexander Hatala
Title
Ceo
Phone
(856) 757-3500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 25MA04819100 NJ Primary

Addresses

Primary practice location

1600 Haddon Ave
Internal Medicine
Camden, NJ 08103-3101

Mailing address

500 Grove St
Suite 100
Haddon Heights, NJ 08035-1761
Phone (856) 796-9200

Other names 1

  • OLOLMC Internal Medicine Hospitalists Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lourdes Surgical Associates7 organizations share this tax ID, including this one
Part of
Lourdes Surgical Associates

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1276732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431475200000",
    "number": "1013238799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 GROVE ST",
            "address_2": "SUITE 100",
            "city": "HADDON HEIGHTS",
            "state": "NJ",
            "postal_code": "080351761",
            "telephone_number": "856-796-9200",
            "fax_number": "856-310-0592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 HADDON AVE",
            "address_2": "INTERNAL MEDICINE",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081033101",
            "telephone_number": "856-757-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUR LADY OF LOURDES MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OUR LADY OF LOURDES MEDICAL CENTER",
        "enumeration_date": "2010-06-17",
        "last_updated": "2015-05-13",
        "status": "A",
        "authorized_official_last_name": "HATALA",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "856-757-3500"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA04819100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OLOLMC Internal Medicine Hospitalists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Camden, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.